B.C. health ministry moves to bar extra billing

The B.C. NDP government is moving to crack down on extra billing by private clinics, while spending more to increase publicly funded surgeries to stem growing waiting lists.

Health Minister Adrian Dix put extra money into hip and knee replacement surgeries as well as dental surgery, aiming for an increase of more than 9,000 additional procedures in the public system between now and the spring of 2019. Magnetic resonance imaging scans got another $11 million to diagnose joint conditions for surgery.

Dix has also put private surgery clinics on notice that they will be subject to greater enforcement of extra-billing for medically necessary procedures. As of October 2018, provisions of provincial law enacted in 2003 are to be brought into force, with repayment orders and fines starting at $10,000 and rising for “wrongly charging patients” for medically necessary surgeries as defined by the Canada Health Act.

“The consequences of the failure of the previous government to enforce the law has cost patients millions of dollars,” Dix said when he announced the new enforcement in April. “This has to stop.”

Three clinics have been audited by the B.C. ministry, with six more to come this year. Based on the initial audits, Ottawa reduced B.C.’s health transfer payments by $15.9 million as of March 2018 for violating the Canada Health Act.

The B.C. Health Coalition, a union-run advocacy group, presented symbolic billings for the $15.9 million Tuesday to clinics in Kelowna and Vancouver.

Meanwhile, the Canadian Institute for Health Information’s latest wait time data found many people waiting beyond the target wait time for hip and knee replacements as well as cataract surgeries in Canada, despite an increase in the number of surgeries since 2015.

International measures consistently show Canada lagging other developed countries in health care performance, behind countries such as the Netherlands, the United Kingdom and Germany, where more than a third of hospitals operate on a for-profit basis while treating patients with public health insurance.

A study released Tuesday by the Fraser Institute argues that Ottawa’s interpretation of the Canada Health Act prevents provinces from pursuing European-style reforms that have produced much faster medical service at similar cost.

Critics of the Canadian system say governments ration care by leaving surgical facilities idle to stay within a public budget, but pay extra for faster treatment for RCMP officers, military personnel and workers’ compensation cases at private clinics.

Dr. Brian Day, a former president of the Canadian Medical Association, continues a lengthy lawsuit challenging the government’s ability to bar procedures from his Cambie Surgery Clinic in Vancouver.